MEDICARE: MS. ERIKA HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	ASW33839	CA

General Provider Information

NPI Number	:	1073895462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA HERNANDEZ

Provider Business Mailing Address
First Line	:	142 E CALIFORNIA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93706-3642
Country	:	US
Telephone Number	:	559-600-1037
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 E CALIFORNIA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93706-3642
Country	:	US
Telephone Number	:	559-600-1037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	03/17/2015

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